Thoughts on OMM

[Drrrrrr. Celty]

Its slow change, but the majority of DOs still go into primary care, and from the programs at major universities, they tend to take DOs into certain programs like PMR and such.

Again, a good amount of that is by choice. My friend who's in the top 20th percentile of the class wants to do FM and rural FM at that because he's into that type of life. I want to do IM or Psych (Big names take DOs in psych and some famous hospitals have DO PDs) and stay away from surgery entirely. Me getting a 260 on the step 1 will not make me want to go do ortho or gen surgery or uro.

Likewise almost a 3rd of my class is married or has kids. Them doing a long residency is out of the question.

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[Seth Joo]

Again, a good amount of that is by choice. My friend who's in the top 20th percentile of the class wants to do FM and rural FM at that because he's into that type of life. I want to do IM or Psych (Big names take DOs in psych and some famous hospitals have DO PDs) and stay away from surgery entirely. Me getting a 260 on the step 1 will not make me want to go do ortho or gen surgery or uro.

Likewise almost a 3rd of my class is married or has kids. Them doing a long residency is out of the question.

That is not the story at my school, I love how schools say that their students "self select" for primary care residencies when it reality, they do not have other options.

 

[MrChance2]

I'm a huge skeptic but most of OMM works very well. I've had a few people that actually needed it tell me after 5 minutes of manipulation that I've fixed constant pain they have had for years. That's pretty awesome to do as a medical student.

OMM gets DO schools a lot of funding. Its pretty much the only field of research where DOs don't really compete with MDs. Cranial is a hot topic to publish on now. To use a metaphor: Imagine how Lars Ulrich would react if you told him that the Black Album is garbage and needs to be removed from the shelves when you are just some Metalhead who heard "Ride the Lightning", loved it and started playing guitar.

 

[Drrrrrr. Celty]

That is not the story at my school, I love how schools say that their students "self select" for primary care residencies when it reality, they do not have other options.

Have you considered the reality that the vast majority of MD students do IM and don't sub specialize either? I mean, I really don't know what you want me to say. The average DO at my school goes into FM, and the average person has a comlex score of 540 and a USMLE 1 at least at 200. That's good enough to end up in almost every specialty osteopathically and in some low to mid range residencies on the MD side. And yet, low and behold, plenty are still going into primary care....

I mean honestly, stop pretending that primary care is a black hole like being some sort of fake doctor. Plenty of people want to go into it, sure at least some percentage maybe 10-20 end up being 'forced' into it ( Lets be frank, they could have choosen all sorts of fields as second best like say OB or Psych or PMR or Neuro, but they went for FM or IM), but that's not to say that the majority does not want to do it by choice.

 

[Drrrrrr. Celty]

I'm a huge skeptic but most of OMM works very well. I've had a few people that actually needed it tell me after 5 minutes of manipulation that I've fixed constant pain they have had for years. That's pretty awesome to do as a medical student.

OMM gets DO schools a lot of funding. Its pretty much the only field of research where DOs don't really compete with MDs. Cranial is a hot topic to publish on now. To use a metaphor: Imagine how Lars Ulrich would react if you told him that the Black Album is garbage and needs to be removed from the shelves when you are just some Metalhead who heard "Ride the Lightning", loved it and started playing guitar. It hurts the true metalheads though and, after the initial uptick, ultimately the entire heavy metal genre.

How high are you exactly?

 

[MrChance2]

How high are you exactly?

Not high at all, sleep deprived maybe but don't worry, my post will make perfect sense after you've done cranial.

 

[JustaDO]

Why did you even enroll in an osteopathic medical school if you don't want to learn osteopathic medicine?

Why enroll? Same reason I enrolled in physics, I have no interest in physics, but am I going to let that stop me from becoming a physician? I have no interest nor desire learning OB medicine, should I not enroll in any medical school then?

Also, tell me, what is osteopathic medicine exactly?

And yes, you are off base if you think that there is truly no scientific basis for any OMM. You clearly have not done a thorough review.

Crazy that it seems most of the OMM research is done and then published in the JAOA.

Please do your colleagues a favor. Either learn to appreciate OMM and what it can do to help alleviate pain and suffering. Or drop out of school and become that allopath you think is so much better. If you should stay in your DO program, do the rest of us a favor and stop trashing our profession.

Do not panic. The waaaaaambulance is on it's way. You poor thing there there.

It seems the only people who are in tears are the DO students themselves, which is sad, since OP was not seeking to offend people, but he came here looking for opinions and thoughts.

Like competition, questions beget better outcomes. What if no one questioned bloodletting?

Please do society a favor, accept that different people have the right to have different beliefs and will continue to do so regardless of your ultimatums.

A famous neurosurgery professor at Johns Hopkins also said that evolution was the work of the devil.
http://www.newyorker.com/news/news-desk/ben-carsons-scientific-ignorance

And numerous osteopathic doctors think that they can move cranial bones.

 

[soon2BdocC]

Why enroll? Same reason I enrolled in physics, I have no interest in physics, but am I going to let that stop me from becoming a physician? I have no interest nor desire learning OB medicine, should I not enroll in any medical school then?

Also, tell me, what is osteopathic medicine exactly?



Crazy that it seems most of the OMM research is done and then published in the JAOA.





It seems the only people who are in tears are the DO students themselves, which is sad, since OP was not seeking to offend people, but he came here looking for opinions and thoughts.



And many osteopathic doctors think that they can move cranial bones.

No tears here, just outrage over an extreme opinion which is based on misinformation. If you don't like OMM, why take a spot in an osteopathic program from someone who is at a minimum open minded?

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[JustaDO]

So OP has a view that mainstream medicine endorses, and he is the one with the extreme opinion? I see.

Why take a spot? He/She wants to be a physician.

 

[ortnakas]

Again, a good amount of that is by choice. My friend who's in the top 20th percentile of the class wants to do FM and rural FM at that because he's into that type of life. I want to do IM or Psych (Big names take DOs in psych and some famous hospitals have DO PDs) and stay away from surgery entirely. Me getting a 260 on the step 1 will not make me want to go do ortho or gen surgery or uro.

Likewise almost a 3rd of my class is married or has kids. Them doing a long residency is out of the question.

I agree with all of this. I think board scores probably affect people's specialty choice on the bottom and top ends of the spectrum, but not most of the middle.

 

[costales]

And numerous osteopathic doctors think that they can move cranial bones.

Wrong. Very few DOs - maybe 1% - take cranial seriously. The only believers I know are OMM professors.

 

[JustaDO]

Wrong. Very few DOs - maybe 1% - take cranial seriously. The only believers I know are OMM professors.

Yet, the number of OMM professors, N > 1, but Ben Carson N =1, so the attempted shot at John Hopkins has no bearing.

 

[costales]

Evidently your experience with and knowledge of OMM is numerous.

 

[Drrrrrr. Celty]

I agree with all of this. I think board scores probably affect people's specialty choice on the bottom and top ends of the spectrum, but not most of the middle.

Right, I'm sure the bottom 10% of your DO class is probably going to end up begrudgingly going into either FM or IM at relatively small community hospitals, but ~40% of your class will choose IM or FM because they want to do that and enjoy it. Like I said before and like I said the moment I made my first cut into my cadaver, I never want to do surgery.

 

[soon2BdocC]

So OP has a view that mainstream medicine endorses, and he is the one with the extreme opinion? I see.

Why take a spot? He/She wants to be a physician.

Yeah, 100 years ago, the MD was nothing without his fleam. Amazing that billions of people lived without 20th century allopaths.

Yes, he wants to be a physician. No one forced him into an osteopathic program. Suck it up, buttercup. You will be tested on OMM for the next 4 years.

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[JustaDO]

Evidently your experience with and knowledge of OMM is numerous.

And your more qualified because you have taken a few more morning / afternoon sessions of OMM that I have not taken yet?

 

[Dr. Death]

Why enroll? Same reason I enrolled in physics, I have no interest in physics, but am I going to let that stop me from becoming a physician? I have no interest nor desire learning OB medicine, should I not enroll in any medical school then?

Also, tell me, what is osteopathic medicine exactly?



Crazy that it seems most of the OMM research is done and then published in the JAOA.





It seems the only people who are in tears are the DO students themselves, which is sad, since OP was not seeking to offend people, but he came here looking for opinions and thoughts.

Like competition, questions beget better outcomes. What if no one questioned bloodletting?

Please do society a favor, accept that different people have the right to have different beliefs and will continue to do so regardless of your ultimatums.



And numerous osteopathic doctors think that they can move cranial bones.

I'm not offended. My opinion and thought is, you want to be a doctor, doing 4-6 hours a week of OMM is a small price to pay given that if you weren't in a DO school you would be on a beach in the Carribean with first aid on your lab and a drink in your hand.

 

[jl lin]

Once you're actually in practice, regardless of the field, you'll realize that EBM is kind of oversold. There's just a lot of areas where you have good anecdotal evidence but there's no money for funding a study or study design just couldn't be done in a practical, effective way.

I mean, yes. I don't know how to get around this; plus it's ongoing research and systematic reviews that gives us more validity to EBM, don't you think? I think It would be interesting to shadow with some physicians that still practice OMM and do it well. Seems like they are dying out though.

 

[jl lin]

Not really, these people have power, they are people in high places in the medical community, its the reason why so many of us DOs often hit a glass ceiling when trying to get residency training at large academic hospitals.

Even Dr. Oz, who promotes a lot of pseudoscience dismissed OMM as such.

Really. I hadn't heard this. Hmm.

 

[NurWollen]

Lol. Oh god that is weird. Did they also speak in a soft voice?

Yep. You bet.

 

[AlbinoHawk DO]

OMM gets DO schools a lot of funding. Its pretty much the only field of research where DOs don't really compete with MDs. Cranial is a hot topic to publish on now. To use a metaphor: Imagine how Lars Ulrich would react if you told him that the Black Album is garbage and needs to be removed from the shelves when you are just some Metalhead who heard "Ride the Lightning", loved it and started playing guitar.

This is laughable. Most OMM faculty don't do any research despite there being a lot of grants for alternative medicine. This is because most of them are not willing to put it to the test. There is no "hot topic to publish" when it comes to any OMM.

As for "pain," I'm going to be another anecdotal and say that I have always felt worse physically after OMM class.

Personally, I think most OMM needs to be stripped away. 95%+ of DOs don't ever use any OMM. It's a waste of time to be putting so much into educating people on a useless topic and then have it on boards. DO schools need to teach a "lite" curriculum on it that's evidence based and directly applicable to how medicine is practiced day-to-day. Leave it to the people that drink the kool-aid to go on and learn Chapman points and Cranial on OMM residencies.

 

[deleted480308]

It doesn't matter if you buy into it, it's a hoop you have to jump through. Whether it's for your clinical good or the cosmos punishing you for not getting into hopkins because your stats weren't there.......this is now your life, cope

 

[costales]

Really. I hadn't heard this. Hmm.

Because Oz never said it. From his web site and video:
http://www.doctoroz.com/videos/cutting-edge-pain-solutions-pt-2
http://www.doctoroz.com/article/best-solutions-your-pain?page=1

Osteopathic practitioners are trained to use the musculoskeletal system as its own self-regulating tool for healing the body. They are trained to use their hands to actually find areas in the body holding tension. Like MDs, doctors of osteopathic medicine have full medical licenses. Since not all causes of pain can be identified on an x-ray, osteopathic treatments can be very helpful. The osteopathic treatment HVLA – high-velocity, low-amplitude articulation – aims to realign the spine so there’s less stress and tension on the muscles ...​

 

[Seth Joo]

This is laughable. Most OMM faculty don't do any research despite there being a lot of grants for alternative medicine. This is because most of them are not willing to put it to the test. There is no "hot topic to publish" when it comes to any OMM.

As for "pain," I'm going to be another anecdotal and say that I have always felt worse physically after OMM class.

Personally, I think most OMM needs to be stripped away. 95%+ of DOs don't ever use any OMM. It's a waste of time to be putting so much into educating people on a useless topic and then have it on boards. DO schools need to teach a "lite" curriculum on it that's evidence based and directly applicable to how medicine is practiced day-to-day. Leave it to the people that drink the kool-aid to go on and learn Chapman points and Cranial on OMM residencies.

About 10 percent of any given class drink the Kool Aid on OMM, some wind up actually practicing it after school. There are a lot of basic science faculty in my school who think its a bunch of nonsense but most never say anything in public for fear of retaliation, they never openly challenge the OMM faculty.

 

[MrChance2]

"This is laughable. Most OMM faculty don't do any research despite there being a lot of grants for alternative medicine. This is because most of them are not willing to put it to the test. There is no "hot topic to publish" when it comes to any OMM."

I respectfully disagree, in the scope of research happening at DO schools it is a hot topic to publish.

"As for "pain," I'm going to be another anecdotal and say that I have always felt worse physically after OMM class."

I did 1/2 the time as well. Untrained people fixing stuff that isn't wrong doesn't help much. I bet if you were recovering from a shoulder injury and the prof treated you then you would feel differently. The most satisfying OMM I've done was when I went back home and was practicing on friends. One guy I did soft tissue and heard like 10 cracks basically anytime I'd touch his back. 100+ cracks and 5 minutes later after I finally got to ME and HVLA he thought I was a miracle worker. It happens, swear to god. My sister is a physical therapist that spent 2 months at a DO school on rotation. She says the DO stuff that she is able to do is what her patients like the most.

"Personally, I think most OMM needs to be stripped away. 95%+ of DOs don't ever use any OMM. It's a waste of time to be putting so much into educating people on a useless topic and then have it on boards. DO schools need to teach a "lite" curriculum on it that's evidence based and directly applicable to how medicine is practiced day-to-day. Leave it to the people that drink the kool-aid to go on and learn Chapman points and Cranial on OMM residencies."

Chapman's points are garbage. Those frustrate me a lot. They have been around 80 years and somehow don't have a single shred of histological or objective evidence. It bothers me that "Chapman said these existed" is considered sufficient evidence to teach them as fact. Cranial is cranial. I asked a couple pathologists while observing an autopsy if the cranial bones can move (pretty much knowing what their response was going to be) and almost got laughed out of the room. Its frustrating sometimes. At the same time DOs saying they are identical to MDs in all ways isn't what the AOA wants, and I can understand why. I'm actually pretty curious to see what happens 15-30 years from now.

Anyway, I just felt like sharing some opinions.

 

[HotLunch96]

Chapman's points are garbage. Those frustrate me a lot. They have been around 80 years and somehow don't have a single shred of histological or objective evidence. It bothers me that "Chapman said these existed" is considered sufficient evidence to teach them as fact. Cranial is cranial. I asked a couple pathologists while observing an autopsy if the cranial bones can move (pretty much knowing what their response was going to be) and almost got laughed out of the room. Its frustrating sometimes. At the same time DOs saying they are identical to MDs in all ways isn't what the AOA wants, and I can understand why. I'm actually pretty curious to see what happens 15-30 years from now.

Chapman's points are still included in osteopathic medial education purely on the basis that a DO (read: holier than MD) "discovered" it. Refuting such a discovery and path to osteopathic enlightenment is deemed sacrilegious. Keeping those fringe aspects of OMM in the curriculum is only attempting to fluff the toolbox of techniques (regardless of their basis in reality) that DOs have and further strengthening the AOA ideology that we are special/holistic/better doctors than those lousy MDs. Certain aspects of OMM are purely faith based and give it a weird culty/religious vibe. By teaching such things as fact with purely anecdotal evidence has turned me sour to the whole notion of using it past medical school.

 

[AlbinoHawk DO]

One guy I did soft tissue and heard like 10 cracks basically anytime I'd touch his back. 100+ cracks and 5 minutes later after I finally got to ME and HVLA he thought I was a miracle worker. It happens, swear to god. My sister is a physical therapist that spent 2 months at a DO school on rotation. She says the DO stuff that she is able to do is what her patients like the most.

I have serious reservations about your anecdote. You had over a hundred "cracks" by using soft tissue? Come on. That's not even a treatment where you're supposed to be getting "cracks." Personally, if someone's bones were doing that over soft tissue, HVLA would be the last thing I'd do. Chances are they have a serious MSK issue that's contraindicated.

 

[DOFOSHO]

.

 

[jakeislove]

is there an OMM technique for reversing vertebral artery thrombosis and acute basilar artery occlusion resulting from cervical HVLA? i just can't figure out which is worse, sore neck or severe permanent neurologic impairment?

How many times has a vertebral artery thrombosis or acute basilar occlusion been directly attributed to OMT since its inception?

 

[Mad Jack]

We've got plenty of cadavers in the lab that proved to me, without a doubt, that the cranial bones do not, in fact, move. It took me fifteen minutes, a saw, a chisel, and a hammer to get those ****ers to budge.

 

[DOFOSHO]

.

 

[jakeislove]

Way, way too many times.

http://forums.studentdoctor.net/threads/hey-chiropractors-knock-it-off.1141203/

I typed OMT.

Seems relatively rare from chiropractic, in relation to other therapies, but that's not a can of worms I care to open.

 

[ortnakas]

Way, way too many times.

http://forums.studentdoctor.net/threads/hey-chiropractors-knock-it-off.1141203/

Cervical HVLA scares me, and I avoid it when possible. That said, we were told the OMM version was safer than the chiropractic version because we keep the neck in flexion which keeps slack in the vertebral arteries. We were also shown papers documenting how rare these events are. I'm still never going to do it as a physician and I wouldn't want it to be done to me particularly, but in someone who's practiced and knows what they're doing I think it's relatively safe.

 

[Rekt]

I typed OMT.

Seems relatively rare from chiropractic, in relation to other therapies, but that's not a can of worms I care to open.

Having personally seen three post-adjustment vertebral dissections in younger people. I'll do my required cervical adjustments and HVLA for the practical, but will never touch it again.

 

[MrChance2]

"I have serious reservations about your anecdote. "
Up to you.


"You had over a hundred "cracks" by using soft tissue? "
Not what I said.


"Come on. That's not even a treatment where you're supposed to be getting "cracks."
Weird right? I had to press down a bit to get some traction, that's all it took. LVLA

"Personally, if someone's bones were doing that over soft tissue, HVLA would be the last thing I'd do."
It was, I did soft tissue and ME first.

"Chances are they have a serious MSK issue that's contraindicated"
He's healthy guy in his lower 30s. I couldn't think of any contraindication. He's still alive. I'd be curious to know what the underlying issue is but I'm pretty sure it wasn't one of the HVLA contraindications.

Anyway, I didn't come here to argue. Everyone's entitled to their opinions, just thought I'd share my experience.

 

[NurWollen]

I feel like HVLA, soft tissue technique, ME, and counterstrain feel fantastic, especially when performed by someone with more practice than I or the average DO student has.

There have been plenty of times when I wake up, get ready for my day, and get to school or something and don't feel 100%, I have a headache, tight neck, or just fee all-around bleh. Sometimes especially my scapulae feel tight. A good Kirksville Krunch does wonders for this kind of thing.

That said, I still question some of the underlying explanations for these processes. Let's say my back and posterior shoulder feel tight and someone diagnoses me with a T4 ERSr. They'll treat it and it will probably feel much better. But do I really think we have the tactile sensitivity to detect with palpation a supposed vertebral body misalignment so subtle that it probably wouldn't show up on X-ray?

And if somatic disfunction of the vertebrae are questionable, where does that leave viscerosomaric reflexes, to say nothing of cranial and chapmans?

 

[AlbinoHawk DO]

"I have serious reservations about your anecdote. "
Up to you.


"You had over a hundred "cracks" by using soft tissue? "
Not what I said.


"Come on. That's not even a treatment where you're supposed to be getting "cracks."
Weird right? I had to press down a bit to get some traction, that's all it took. LVLA

"Personally, if someone's bones were doing that over soft tissue, HVLA would be the last thing I'd do."
It was, I did soft tissue and ME first.

"Chances are they have a serious MSK issue that's contraindicated"
He's healthy guy in his lower 30s. I couldn't think of any contraindication. He's still alive. I'd be curious to know what the underlying issue is but I'm pretty sure it wasn't one of the HVLA contraindications.

Anyway, I didn't come here to argue. Everyone's entitled to their opinions, just thought I'd share my experience.

We are all entitled to our opinions but not to the facts that we want to be facts. Medicine needs to be evidence based, and when we know at least 30% of people in trials respond to placebo, we can't use anecdotes as a way to justify what we do.

 

[soon2BdocC]

We are all entitled to our opinions but not to the facts that we want to be facts. Medicine needs to be evidence based, and when we know at least 30% of people in trials respond to placebo, we can't use anecdotes as a way to justify what we do.

But the evidence is sometimes proven wrong. Just this week skim milk was given the boot because the science over time proved faulty. We need to be discerning, choosing our evidence wisely. Anecdotal experience is how we learn what EBM is valid and which is better purposed as fertilizer.

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[JustaDO]

But the evidence is sometimes proven wrong

Like OMM's evidence?

 

[Apoplexy__]

I feel like the Osteopathic forum has a very standardized set of reactions to people questioning OMM:
1. "It's ok that there's no science behind it, reimbursements are high"
2. "You're just an M1, you don't deserve an opinion"
and the best...
3. "If you don't like OMM, you shouldn't have become a DO"

This thread was a winner with all of the above.

 

[deleted407021]

I feel like the Osteopathic forum has a very standardized set of reactions to people questioning OMM:
1. "It's ok that there's no science behind it, reimbursements are high"
2. "You're just an M1, you don't deserve an opinion"
and the best...
3. "If you don't like OMM, you shouldn't have become a DO"

This thread was a winner with all of the above.

And what are essentially "have faith" statements.

 

[DrMcCoyDO]

Me personally, went into first year all gung ho about OMM. I bought into everything, even Chapman's points, and got upset about people disparaging this awesome tool. Then we got to cranial and the comments, even from professors, of "just imagine you can feel it" or "learn it, since it's on boards." I couldn't understand how these intelligent people who I respected could buy into this obvious woo-filled junk. That's when I started questioning it all. Now in my second year, I definitely enjoy muscle energy and soft tissue techniques at this point and can buy into some counterstrain; I've found that they can be useful, but I have no desire to use any OMM in my future practice. For now, I'm mostly just trying to glean the legit material I can get from class and learn what I need to know for boards.

 

[Seth Joo]

Me personally, went into first year all gung ho about OMM. I bought into everything, even Chapman's points, and got upset about people disparaging this awesome tool. Then we got to cranial and the comments, even from professors, of "just imagine you can feel it" or "learn it, since it's on boards." I couldn't understand how these intelligent people who I respected could buy into this obvious woo-filled junk. That's when I started questioning it all. Now in my second year, I definitely enjoy muscle energy and soft tissue techniques at this point and can buy into some counterstrain; I've found that they can be useful, but I have no desire to use any OMM in my future practice. For now, I'm mostly just trying to glean the legit material I can get from class and learn what I need to know for boards.

The main thing I got out of OMM is that its a great way to increase income for those of us who wind up becoming primary care physicians.

 

[wjs010]

I feel like the Osteopathic forum has a very standardized set of reactions to people questioning OMM:
1. "It's ok that there's no science behind it, reimbursements are high"
2. "You're just an M1, you don't deserve an opinion"
and the best...
3. "If you don't like OMM, you shouldn't have become a DO"

This thread was a winner with all of the above.

Lol. Yea since such a giant population of DO's practice OMM.

 

[DOFOSHO]

.

 

[GUH]

the "omm that really does work" ie. muscle energy, hvla, soft tissue is stuff that people have been doing for millennia. you don't have to go to a DO school to learn how to contract-release-stretch your muscles, or pop your own back/knuckles, or get someone to rub your back and neck. those techniques are nothing special, its that same stuff you get your mom or your girlfriend or cat to do for you. the argument that "some omm works" is flawed in that the techniques are just old pass-me-downs that DO farts learned how to capitalize on.

It works for some of the most common complaints doctors get, therefore don't teach it? Does not compute.

 

[GUH]

Lol. Yea since such a giant population of DO's practice OMM.

There are many things a DO is expected to have a basic knowledge of that most DOs do not actually use out in practice. It doesn't mean that we get to sidestep topics that we don't like studying. If that were the case then they should also remove histology from the osteopathic medical curriculum as well. But that would be silly.

 

[DOFOSHO]

.

 

[Bacchus]

A famous neurosurgery professor at Johns Hopkins also said that evolution was the work of the devil.
http://www.newyorker.com/news/news-desk/ben-carsons-scientific-ignorance

You win the thread.

 

[jl lin]

No, I haven't looked into any numbers or research that states this in absolute terms; but I wonder. How many DOs in practice across the US use OMM on a regular basis in their practice? What are the profiles of those that do so? Were they trained 20 years or more ago, and did this make a difference in their level of proficiency?